Thursday, May 31, 2007

36 hours Post Op, What to expect following implant surgery






My purpose for writing this blog was to detail my experiences in having a penile implant because I have experienced erectile dysfunction as a result of 20 years of diabetes. Your ED may be from diabetes, smoking, or high blood presure, or you may be impotent because you had surgery to remove a cancerous prostate. What ever the reason, you did not choose to be impotent, but it happened to you. And you want to continue to be a sexual man, like you used to be. You have someone special in your life that you want to express sexual love and joy with. I do, and I've been married for 26 years and I enjoy making love to my wife. I've tried it all for 13 to 14 years of experiencing Erectile Dysfunction. Injections by the hundreds, but now the injections are causing scar tissue in the all important erectile tissue of the corpora cavernosa. Viagra and cialis gives me a so so erection along with a head ache and and a blocked up sinus. I've tried vacuum erection devices, yuck. Enough said about that experience. So, whats left for a guy who wants to enjoy sexual relations? A penile implant is what you and I would have left to choose from at this point. When everything else has failed, the best choice left to you or me is a surgical implant. Lets face it, penile implants have over a 92% satisfaction rate from actual implant users. It also enjoys a high level of satisfaction from implantees partners as well. Viagra, Cialis and Levitra only have a 50 % satisfaction rate. Implants work. It's the surgery part that sucks and is the reason that an implant isn't the first choice.



I had my implant surgery just 36 hours ago. But prior to getting to where I am now, I have done a tremendous amount of research online as well as spending many hours of personal research in the medical library at the University of Missouri in Columbia, Mo. What I found for information on what to expect from having implant surgery really sucks out there. I'll bet that you are also unhappy with the information that you've been able to discover through your own reseach. Having surgery on your penis is a big deal and it takes some real thought to get over the fear of letting a doctor permantly change the only sex organ that you will ever have. It's not a decision you want to make a mistake with, does it?



I'm sitting here now, 36 hours post-op. I had an AMS 700 Ultrex implanted into my penis. This implant is very reliable and I expect it to serve me for around 10 years or more. It may fail me sooner, or it may last me for the rest of my life. I'm 52, and in pretty good health. Who knows! I may loose some length from my erection or have an infection or lasting pain. So far, the pain is pretty manageable. Doesn't look like any problems yet with infection but time will tell. I had 5.5 inches in length and was 5.5 inches in circumference. I may have thicker or thinner girth and I maybe longer or shorter as well. Right now, I don't have any answers yet. But in 6 weeks, I'll let you know.

At 36 hours post op as you can see from my pictures, you will start to see swelling and bruising. My penis and scrotum looks pretty ugly right now, and looking at the pictures of my sex organ, you would probably say say no way am I going through that. Am I in pain? No. I actually feel pretty good other than feeling like I have a black and blue looking grapefruit sized mass between my legs. You got to keep a sense of humor at this stage of the implant. I came home with a bottle of vicodin for pain relief and a bottle of keflex antibiotics to prevent an infection. As it is, I only need the vicodin at night, and a couple of Naproxen Sodium (Alieve) are taking care of the pain during the day which isn't much pain right now. In emailing back and forth among other implantees, what I'm experiencing is pretty common. I'll be swollen and bruised for about a little over a week or more. I want to give the reader the truth about my experiences, so that you can make an informed choice for yourself. Your partner also needs to understand what and why you may be thinking of getting an implant. This implant is going to effect both of you, so don't shut them out. If you do decide on an implant, learn as much as you can and then find a good experienced doctor. My doctor is a board certified Urologist and is a teaching doctor at the University of Missouri, Hospitals and Clinics in Columbia, Mo. Dr Weinstein performed my vasectomy almost 20 years ago and has done hundreds of implants. So I was in pretty good hands. Well, it's getting time for bed. I'll add more about my experiences later.

Thursday, May 31, 2007






Dear Readers

The largest part of the swelling in my penis has gone down, i.e., theforeskin and the penile skin were HUGE and distorted, but that's all back to normal. There is still swelling in the penis, but it's better, and there is no black and blue left. The scrotum remains uncomfortably tight, and I can't even feel the right testicle. I told the urologist that I thought it was tangled up in the web of device within, but he found it and assured me that it was just fine, that there is still so much swelling. I went back again today to see if he could deflate me some more, as I was having to "ride high" todayto go to work, I just wore briefs and kept it up on my abdomen. He did push the button and squeezed some more fluid into the reservoir, but it's still pretty stiff and uncomfortable I think that's what's causing all the burning I'm feeling, but so far it hasn't seemed to rise back up to the level it was when I went this morning. I'll just be glad when all this is over..it's been very painful.I do have the new pump also, that you mentioned. He showed me where the release button was, but now that I'm home, I haven't been able to locate it. I'm sure it's all a learning process!!

Post OP emails





I had the same progression. Things will get better in five days toa week after surgery. When did you doctor say you could takeshowers? How long did he say to wait until you took warm baths?Those helped more than anything.> Meanwhile, ice packs help relieve the swelling.>> RB

Robert:No baths for two weeks. But I get to take warm showers 48 hourspost-op. I wonder if a heating pad would help to bring down some ofthe post-op swelling and bruising. For now, I'm just using an icebag. I learned from my vasectomy 20 years ago, that icing the areaholds down the pain a bunch. I took percoset last night for painand to sleep, but today Naproxen Sodium (Alieve) is doing a good jobof taking care of any pain I might have. Even though I've gottenpretty swollen, I'm not hurting at all. It just looks a whole lotworse than it feels. And it no longer hurts to pee, so theirritation from the catheter has gone away. I'm still glad that Ihad this done. All of the hard stuff is behind me at this point.

Thursday, May 31, 2007





Afternoon Gary:
You had it right, I've worked in health care for 17 years inHistology. Also did a lot of Gross Disection as well as doing frozen sections. I had to change careers 7 years ago due to some serious carpal tunnel in both hands. I now work in Family Medicine doing computer support for our dept and clinics at the University ofMissouri, Hospitals and Clinics. I'm doing great post-op painwise. I took percocet last night to sleep. But I'm using NaproxenSodium today and its taking care of the pain just fine. Also trying not to take too much of the narcotic pain meds so I don't want to have constipation problems. I got home yesterday afternoon from the hospital and had a little bit of swelling and bruising, but things have increased today to the point that I'm showing considerably more bruising and swelling to my penis and scrotum. I'm just taking it easy on the couch with an ice bag. Although my scrotum is pretty swollen, it doesn't hurt right now. I did notice a difference in the pump size. I was told that my implant has a new pump that is coming out now with the Ultrex. Dr Weinstein said he didn't think this revision was going to be out for a month or so, as he didn't think it was in production mode yet, but it is about a third smaller and it has an easier pump on it, much like the pump on the albacor device. I can feel it in my scrotum. They implanted the reservoiron on my right side inguinal passage as it is a little tender there, but does not feel too bad. Now that the hard part is behind me, its wait and see time. Even though I've taken thousands of shots in my lifetime, now that I've got an insulin pump and a penis so to speak pump,almost no shots anymore. I do take allergy shots though. The human pin cushion, thats me. When I was 16, I was in the hospital recovering from a car accident and my roomate was learning how to give himself shots. And I though, "Thank God, I don't have to take shots". God has a sense of humor because he gave me insulin shots for diabetes, shots for an erection, and last but not lease, allergy shots. I was a good customer of Bectin Dickinson. Slowly but surely, I'm getting weaned off shots. I've read about some advise to inflate the device on a daily basis and that sounds like good advice. Normal nightly erections keep the penis stretched and oxgenated. With the implant,the oxygenation no longer ocurrs, but it does make sense to keep the tissue stetched out. That's what I plan on doing when I can startusing the implant.Take careBob---

In http://health.groups.yahoo.com/group/penileimplant/post?postID=-ROAF6YvVu_oD2bC1GKhQpZgrfmxfP1SGLd830SFK8tmNyEgOpNXowOmG-ZLjNWWRtcQ26FHXirN--Br2LU_fJdTQT-pFw, "grrich2763" mailto:grrich2763@...

YEAH!! Glad it's over for you, Bob. Sorry it was more of anordeal than it should have been. Working in surgery (anesthesia) I cantell you that these kind of things happen, not real often, but they do unfortunately. Do you or your wife work in health care, lol, seems like it's always our own staff that have the FUs. As long as the> procedure went well, the frustration from all the damn waiting is> over. And it sounds like you got the best and latest, and all you report about edema, bruising etc is to be expected. This area ofyour body is very well vascularized, so all of this will dissipate rapidly. Unless you over do, so follow the instructions. The implants I've seen, do seem to be made of pretty stiff tough stuff, not sure the material, has to be some form of silastic. I guessI'd get used to it being a little bit firm, and somewhat out there, as long as getting dressed was not going to be a problem. I know I certainly have noticed when I"m completely flaccid, which is mostof the time I"m afraid, that the shaft of my penis is shorter, looks almost like I was not circumcised, and I know this is because ofthe inch or so of urethra that was removed with the prostatectomy,hence creating a slight traction of the distal urethra/penis back into the pelvis. It still stretches to full size with injection or VED, so not real worried about that, but having an implant push it out would not be an issue I guess. I do sometimes wonder if sexual responsivenes > would be better if I just left the glans covered like it is now flaccid, which is the argument by those lobbying for restoration or preservation of foreskins. I've asked guys b4 and wonder if some enjoy partially filling it during the day just to give that fullness in your shorts we all like. Seems like it would not be a problem. Anyhow, too early to be concerned about the recreational side ofthis, just glad the procedure went well. Did you find your surgeon just because he was local, or did you travel for him? Keep us posted. Gary

Post Op Replies

Daniel:I'm getting more and more swollen and black and blue as the day isgoing. My scrotum is pretty tight right now. Feels like I've got agrapefruit between my legs. But surprisingly, I'm not having muchpain. Just a couple of Aleive and I'm doing fine. It's surprisedme that the swelling would increase two days after the surgery. Ijust wonder when the swelling and black and blue will go down?--- In penileimplant@yahoogroups.com, "dojenncl" wrote:>> Bob, I had the Ultrex implanted last Monday, but I don't have aclue> as to which kind of pump was used. The rep was there, as I> understand, but they may have used the older version. You were> fortunate to get yours deflated so quickly..I just got that done> today, and it doesn't seem to have deflated enough, so it's still> rather stiff, and at a 45 degree angle. The deflation process was> rather painful, and I've waited a week, so I can imagine for youit> was really painful so quickly after surgery. I'm still in a lotof> discomfort. I'm sure part of it is that your surgeon may havedone a> lot more of these than mine has. I plan to go back in a couple of> days and see if he can deflate it some more or it may be just that> the tubes are providing this much stiffness. Good luck in your> recovery.> Daniel

Post Op replies

YEAH!! Glad it's over for you, Bob. Sorry it was more of an ordealthan it should have been. Working in surgery (anesthesia) I can tellyou that these kind of things happen, not real often, but they dounfortunately. Do you or your wife work in health care, lol, seemslike it's always our own staff that have the FUs. As long as theprocedure went well, the frustration from all the damn waiting isover. And it sounds like you got the best and latest, and all youreport about edema, bruising etc is to be expected. This area of yourbody is very well vascularized, so all of this will dissipaterapidly. Unless you over do, so follow the instructions. Theimplants I've seen, do seem to be made of pretty stiff tough stuff,not sure the material, has to be some form of silastic. I guess I'dget used to it being a little bit firm, and somewhat out there, aslong as getting dressed was not going to be a problem. I know Icertainly have noticed when I"m completely flaccid, which is most ofthe time I"m afraid, that the shaft of my penis is shorter, looksalmost like I was not circumcised, and I know this is because of theinch or so of urethra that was removed with the prostatectomy, hencecreating a slight traction of the distal urethra/penis back into thepelvis. It still stretches to full size with injection or VED, so notreal worried about that, but having an implant push it out would notbe an issue I guess. I do sometimes wonder if sexual responsivenesswould be better if I just left the glans covered like it is nowflaccid, which is the argument by those lobbying for restoration orpreservation of foreskins. I've asked guys b4 and wonder if someenjoy partially filling it during the day just to give that fullnessin your shorts we all like. Seems like it would not be a problem.Anyhow, too early to be concerned about the recreational side of this,just glad the procedure went well. Did you find your surgeon justbecause he was local, or did you travel for him?Keep us posted.Gary

Wednesday, May 30, 2007

Day of Implant, AMS700 Ultrex with new Pump






Dear Readers

It's Tuesday, May 29, 2007 on or about 9:00 am and I'm at University Hospital in Columbia, Mo and I'm checking into (DOSA) Day of Surgery Admit. I get the paperwork completed, get the wristband, and then am told to wait until about 10:00 am as surgery is running a little behind. At 10:00 am, I am taken in where I get changed into a gown and lines put in. Around 11:00, Dr Weinstein informs me that they had received the wrong implants from AMS on Friday. They had received an AMS Ambicor and a AMS 700 CS, but no AMS 700 Ultrex. I have a couple of choices. He can implant the Ambicor or I can wait and they will have the AMS rep bring one to Columbia from ST Louis, and I'll have my surgery later that afternoon. I decided to stay with my decision to go with the Ultrex implant even with this FU situation. My Dr had the rep called and he started surgery on another patient with an infected kidney removal. The decision is made to move me up to the 7th floor to wait, and wait and wait. Now I haven't had anything to eat since midnight and nothing to drink since 6:00 am. Around 6:30 pm, they finally bring me down for surgery and I wait while they clean up the OR from the last patient, the nephrectomy. I was wheeled in a little after 7:00 pm for surgery. I woke up around 11:00 pm with some pain, but my surgery is over. Most of the pain that I'm feeling is from the catheter. I was later told that for the surgery, they put in a larger catheter, but replace it later with a smaller catheter when the surgery is almost over. It does leave you sore though, and hurts like they're dragging razor blades out through my penis, they finally removed it and I started feeling much better with it out. My penis is really sore when I urinate, but otherwise, I only have a dull aching pain. I got discharged today with a script for percocet and a script for keflex. I didn't have a lot of swelling and black and blueness, but as the day goes by, I'm turning black and blue more and more on the base of my penis and growing into my scrotum. I did learn from my Doctor today that my implant has a new type of pump that Dr Weinstein didn't even know was available yet for the Ultrex. It's smaller by about a third than the old pump pump that was coming out just recently with the AMS 700 series. To deflate the pump, you press on the button for 4 seconds and then release and the implant deflates. It also features an easier pumping mechanism similar to the Albacor pump. He hadn't figured on it even being available for several months from now. The AMS Rep from St Louis brought it down and stayed for my surgery and advised him on this new implant. This morning, one of Dr Weinsteins residents, a women urologist came to my room to deflate my pump all of the way. God did that hurt. She tried to deflate my pump like the older pump as she wasn't familiar with the deflation mechansim. I did get instructions on this new pump with the paperwork I received, and Dr Weinstein deflated by implant all of the way. Now, I'm home sitting with my ice bag in my lap and not moving too fast. The restrictions I received are: no lifting over 20 lbs for two weeks; no driving while on the pain meds; antibiotics every 6 hours for two weeks (keflex); no sitting in a bath, showers with no direct stream of water onto my penis, wash with a mild soap on the incision and pat dry; the stitches are desolving ones; no sex or use of the implant for six weeks. And take off two weeks from work. Thats all for now. I ll add more later.

Saturday, May 26, 2007

The AMS Family of Implants






The AMS Ambicor is a two piece prothesis that enjoys the highest satisfaction rate of all the implants available for men who have Erectile Disfunction. It also hold the distinction of having a higher level of satisfaction over all methods that a man can use to over come his ED. This implant is easier for a surgeon to implant as their is no reservoir to implant inside the abdomen. It has two cylinders that implant into each chamber of the corpora cavernosa, along with the pump which is implanted into a man's scrotum. This implant enjoys an extremely high reliability index. Far above the other implants available. In the January 2007 issue of the Journal of Urology reported on the AMS Ambicor implant and this implant also is very easy to inflate. It only needs 5 to 6 pumps to produce an erection. This implant does not expand the girth or the length of the penis and does provide a very suitable erection.

The AMS 700 CX is a 3 piece implant that provides for expansion as well as a very stiff erection.
It does require the surgion to implant a reservoir in the abdomen. It also has a very high degree of satisfaction among users.

The 3rd three piece implant is the AMS 700 Ultrex implant. This is the AMS implant that is the most pospular implant available for implantation. It also has three parts. There are two cylinders that are implanted into the Corpora Cavernosa. Attached to the cylinders via tubing is the pump which is implanted within the mans scrotum. The reservoir is implanted into the lower abdomen via the inguinal opening along side the vas deferen. This implant is the most popular because it has expanded girth and expands in length as well. It's a well known fact that the majority ofmen loose some length on their erection. Some don't loose any, and some gain length up to 3 centimeters. 1 inch equals 2.5 centimeters. For men who have had abdominal injuries that have left scar tissue. The Ambicor is the implant of choice. It is also chosen when the man has limited dexterity. It is very easy to pump to erection and also easy to deflate. Because not all of the fluid is drained from the cylinders, men don't completely go flacid, so its not as natural looking as the AMS 700 series implants.

I have chosen the Ultrex as my choice in implants and will have it implanted on Tuesday, May 29th.

Nuclear Stress Test, Friday May 25th






Hi everyone:

I go in under the knife on Tuesday, May 29th for my implant surgery. Friday was a pain in the a@@. I was told Thursday that the cardiologist saw an abnormal Q wave on my EKG, so they want me to have a stress test with radioactive contrast or a Nuclear Stress Test. The protocol calls for me to raise my heart rate above 140 beats per minute. I hit the gym three, four times a week and do 5 miles on the tread mill with no problems at my gym. They had me jogging at 5.5 mph with a 15 per cent grade and I'm jogging along with a 126 beats per minute rate and I can watch the EKG which is running right next to me. I've ran EKG's when I worked in Cardiac Research years ago and I'm commenting to the EKG tech, so where are all those abnormal Q waves. I don't see a one. He tells me that they get Nuclear Stress tests ordered on all diabetics from this one Anesthesiologist who will be on my surgery team. They decided to run the test with a 126 bpm because I'm not going to higher, so the radiology tech pushed the radioactive material into me and I took the test and had the scan. Wasted a whole morning missing work having a totally useless test because doctors have to practice defensive medicine. Wonder what my insurance costs would be if the sue crazy world took a year off. I did find out that my test showed no evidence of infarcts in my heart or clogged arteries or any evidence what so ever of heart desease. I test at 160 % higher than my age group and have less than a 5 % chance of having significant cardiovascular desease or dying from it. Not too bad for an old guy with 22 years of Type 1 diabetes. Anyway, I'm cleared to go Tuesday morning and the stress test shows that I keep myself in good physical condition for being 52 years old. I'm alergic to morphine since my last surgery, so I wonder what I'll get for pain meds following surgery. I've read dojenncl post and I wonder if I'll be swollen and sore following surgery like he was. I've also settled on having the AMS 700 Ultrex implant. The wife and kids are at a wedding all this weekend. I'm keeping busy getting all of my honey-do''s done before I'm too sore to do much of anything for awhile.

Wednesday, May 23, 2007

Post Op Implant Visit





Today I was scheduled for my Pre-Op visit. I met with my doctor, had blood pressure checked, went over my meds, had a chest XRay, had blood drawn, and met with anesthesia. Received information about no food after mid-night on day of operation, and just clear fluids from mid-night until 7:00 am. My surgery was set for 9:00 am, Tuesday May 29th, so now its wait and see. I have all Memorial Day weekend off prior to reporting for my implant surgery. I feel good, all my questions have been answered, and physically I check out. All of the Pre-Op stuff took two hours to complete. My expected time in the OR is 60 to 90 minutes.

Wednesday, May 16, 2007

My Decision, AMS 700 Ultrex






I've done just a ton of research on implants and I'm starting to reach a little burn out. There are lots of repeat information on the web and it gets old real fast. There aren't too many 1st person accounts on the web either. The accounts on Yahoos penileimplant support pages kind of leans out from 1st person accounts of implant users who have long term experience with their implant for longer than 6 months. Unfortunately, men who have had a prostatectomy because of cancer, do loose real length of one to one and a half inches in the length of their penis, even with the AMS 700 Ultrix implant which expands in both length and girth. There is only so much that the implant can do for those of us who are living with ED. My ED started appearing in 1994 at age 39. I'm 52 now. I've had just over 13 years experience with ED and developed diabetes over 20 years ago. I am now on an insulin pump and have pretty good control of my blood sugars. But whether its prostate cancer or diabetes or high blood pressure damaging our ability to achieve an erection, and to enjoy normal sex, for some of us, viagra, cialis, and vardenafil stops working, or we develop a tolerance or scarring from injecting bi-mix. tri-mix, caverject, muse or some other combination of drugs to achieve an erection suitable for enjoying penetrative sex. We as men equate our erection as what it means to be a sexual man. And it comes down to having a penile implant as a means of achieving an erection suitably hard enough to accomplish penetrative sex. Penile implants are called the option of last resort because there is no going back once we've gone down that road as it destroyes the tissue in the corpora cavernosa. That is the tissue that fills with blood that we use to get hard. Yet, the implant enjoys the highest level of satisfaction of all the options available to men with ED. I've reached that point now as injections no longer do the job anymore. And because I've used bi-mix for about 13 years, I now am having fibrosis (scarring) in my penis that is easily felt. Scar tissue does not allow blood to fill the chambers of the corpora cavernosa, and scarring interferes with the implants ability to expand. So that is why it is important to pay attention to your penis if you inject vaso-dialators into your penis. If you feel hard nodules in the areas that you inject, you need to see a urologist or your primary care physican, swallow your embarassment; and ask the doctor to check your penis for scarring.

Insurance Plans & Implants
Guys, insurance companies need to have a letter of medical necessity from your doctor before approving an implant surgery. Doctors (Urologists) who perform penile implants, understand what is needed to document the need for an implant, and have skilled nurses and transcriptionist who have sample letters already prepared to obtain the required approval for your implant surgery. Most insurance companies are looking for evidence of a period of time experiencing ED, along with experience of at least trying different ED meds that haven't worked out or are no longer working. Don't worry a lot about the insurance company denying you because an erection is only needed for sex. ED is a body part that has failed and is a quality of life issue. If you have carpal tunnel, the insurance company can't deny you because you can still use your other hand. Courts have creamed insurance companies for trying to deny legitament claims for quality of life issues. Viagra is a prescriptive medicine and so can be denied, but an implant is a surgery to fix a body part that no longer works as it shouldand is a body part that atropies if not used on a regular basis. Implants have a proven history of use. Let your doctor fight with your insurance company. If the insurance company denies you, obtain a copy of the doctors letter, spend a few hundred bucks and let an attorney threaten a law suit against your insurance company. Your chances of getting an approval is pretty good. Hang in there. Bob

Monday, May 14, 2007

Surgery Date set for penile implant






My Uro called and I go in on Wed May 23rd to go over things with my Uro and meet with Anesthesia. Also need to pick up scrips for antibiotics. Then I have to wait for May 29th for surgery. I've done a ton of research both on the internet and since I work at a University Hospital with a rather large medical library, I've been able to access several significant periodicals that I could not access off of the web. I was having to choose between the Ambicor 2 piece and the Ultrex three piece devices. The Ambicor is not old technology, but a very reliable choice in implants. A large study in the January 2007 issue of the Journal of Urology show that it has the highest satisfaction of all the implants out there both from the patient and partner point of view. Out of a 101 patients from 3 months to over 10 years, 97% of the patients were still using the implant. 1 implant was removed for revision due to pain from incorrect measurement. One implant was removed for infection and one was removed for mechanical breakdown. With a mean period of 38 months. If I were having really poor control of my diabetes, the Ambicor would have been my first choice in an implant because of risk from infection. Because I have excellent control of my Type 1 diabetes over a 22 year period, I'm going to go with the AMS 700 Ultrex implant because of the expansion of the device which has the potential of increasing girth and length. My girth according to my spouse doesn't need expansion as she is satisfied with the fit.

Saturday, May 12, 2007

penile implants






I visited my Urologist yesterday (Dr Weinstine) to discuss being implanted with a penile prosthesis. A little bit about me. I'm 52 years young, a juvenile diabetic since age 31 and have been been diagnosed as having erectile dysfunction for the past 13 years. I've also been married for 26 years to a very understanding and wonderful wife who just had open heart surgery March 30th of this year. I've tried vacuum pumps (hated them), viagra and cialis and have used injections for thirteen years with pretty good success. My wife loves the erections I had from bimix or trimix in that even after ejaculation, I remained hard for about two hours. Why am I considering an implant at this time? My penis is showing signs of fibrosis or scarring from the shots and the shots are loosing their effectiveness. The implants are considered the last resort in that there is no going back to anything else. The implants destroy the tissue in the Corpora Cavernosa which is what fills with blood. I've done a ton of research and have worked previously in PATHOLOGY and have examined numerous explanted devices that failed in patients for one reason or another. But I'm still a little undecided on which implant I want to have implanted. I thought I wanted the AMS 700 Ultrex which is a 3 piece device that expands to increase length and girth somewhat, but there is a 4 % failure or infection rate that requires removal of the device in the first 48 months. My urologist also showed me the AMS Ambicor two piece device and also told me about an article in the January issue of the Journal of Urology. This devise has less than a 2 % failure or infection rate over 48 months as well as a high satisfaction rate among users and their spouses or partners. I need to make up my mind by Monday which is two days away. I also am hoping to have the surgery on May 29th. I plan to keep this blog over the next six month to a year so that others can read about my experiences and can email me with questions. Having this surgery is a scarry situation. I know that I will have significantly more pain following this surgery than I had with my vasectomy. The same surgeon\urologist who did my vasectomy 20 years ago will do my implant as well. A very skilled doctor at University Hospital in Columbia, Mo. Some of my concerns are the same as other men have. Size and width following the surgery. I have a 5.5 inch erection with a 5.5 inch circumference when erect which fits my wife like a glove. So we are very compatible sexually. These devices don't last a lifetime and do fail after time. They have an estimated 10 year lifespan. The Ambicor device is very easy to pump up, has a smaller pump placed in the scotum, and is easier to implant for the surgeon. The satisfaction level with this device is very high and it is simple to use. it only requires 3 to 5 pumps to obtain a satisfactory erection and is very durable. On the other hand, a significant number of men report a loss in size with implants, especially men who have had prostate removal. The Ultrex allows for expansion in girth and length. Some men reported thicker erections and longer erections with the Ultrex. The Pump in the scrotum is larger and a little more complex to use. Also, the reservoir is implanted within the body in the lower abdomen. And the reservoir has to be connected to the pump and filled with saline which increases the risk of infection. AMS has coated the Ultrex with antibiotic to reduce the infection rate. The Ambicor comes from AMS presealed with a saline supply and is simpler and easier to implant so that is an important consideration. Guess I had better get back to my research.